目的探讨重症急性胰腺炎的治疗方法。方法回顾性总结重症急性胰腺炎６９例的治疗情况。结果其中保守治疗４０例，手术治疗２９例。保守治疗重症Ⅰ级３７例，死亡１例；重症Ⅱ级３例，死亡１例。手术治疗重症Ⅰ级６例，均治愈；重症Ⅱ级２３例，死亡４例。结论重症急性胰腺炎有胰腺感染和并发症者应行手术治疗；对年龄大于６５岁者，因更易出现多器官功能衰竭，可适当放宽手术指征；其余的患者则行积极的保守治疗。 Objective To explore the treatment of severe acute pancreatitis. Methods A retrospective review of 69 cases of severe acute pancreatitis treatment. Results of conservative treatment in 40 cases, 29 cases of surgical treatment. Conservative treatment of severe grade Ⅰ 37 cases, 1 case of death; severe grade Ⅱ in 3 cases, 1 died. Surgical treatment of severe grade Ⅰ 6 cases were cured; severe grade Ⅱ 23 cases, 4 deaths. Conclusions Patients with severe acute pancreatitis who have pancreatic infection and complications should be surgically treated. For those over 65 years of age, surgical indications may be relaxed due to more prone to multiple organ failure. The remaining patients undergo aggressive conservative treatment.